Clinical nutrition ESPEN最新文献

{"title":"Dietary sodium and potassium intake and risk of diabetes in the Million Veteran Program","authors":"Xuan-Mai T. Nguyen ,&nbsp;Yanping Li ,&nbsp;April R. Williams ,&nbsp;Neha Panigrahy ,&nbsp;Mark S. Nyaeme ,&nbsp;Kerry L. Ivey ,&nbsp;Daniel D. Wang ,&nbsp;Serena Houghton ,&nbsp;Hasan Mahbub ,&nbsp;Walter C. Willett ,&nbsp;Frank B. Hu ,&nbsp;John Michael Gaziano ,&nbsp;Lawrence Phillips ,&nbsp;Peter WF. Wilson ,&nbsp;Kelly Cho ,&nbsp;Luc Djousse ,&nbsp;the VA Million Veteran Program","doi":"10.1016/j.clnesp.2025.102882","DOIUrl":"10.1016/j.clnesp.2025.102882","url":null,"abstract":"<div><h3>Background/objective</h3><div>Studies show an association between elevated blood pressure, obesity, and insulin resistance with a higher risk of developing diabetes. As sodium is closely linked to elevated blood pressure and hypertension, and potassium is a counterbalancing nutrient to sodium, this study examines the association between intake of sodium, potassium, and sodium: potassium (Na:K) ratio and the incidence of diabetes.</div></div><div><h3>Design setting and participants</h3><div>Retrospective data analysis of dietary intake measured by a validated food frequency questionnaire in a prospective cohort of veterans participating in the Million Veteran Program (MVP) between 2011 and 2020, who were free of diabetes at baseline.</div></div><div><h3>Main outcome measurement</h3><div>The main outcome is clinically diagnosed diabetes defined by phenotyping algorithms applied to electronic health records.</div></div><div><h3>Results</h3><div>In this study of 198,049 veterans (mean age: 63.8 ± 13.1 years, 89 % male), 7260 were diagnosed with diabetes over a mean follow-up of 4.3 years. The mean sodium intake was 1218 mg/day. A higher sodium intake was associated with an 11 % higher rate of developing diabetes (hazard ratio, HR) comparing extreme quintiles: 1.11, 95 % CI: 1.03–1.20). The average daily potassium intake was 2589 mg and the highest quintile of potassium intake was associated with a 13 % lower rate of diabetes (HR: 0.87, 95 % CI: 0.81, 0.94) compared to the lowest quintile of potassium. Highest quintile of Na:K ratio was associated with a 21 % higher rate for diabetes (HR: 1.21, 95% CI: 1.12, 1.30). The pattern of associations between Na:K ratio and diabetes closely followed the pattern of dietary sodium intake and diabetes associations.</div></div><div><h3>Conclusion</h3><div>A higher sodium intake and a higher Na:K ratio were associated with a higher risk of diabetes in this large cohort of veterans. These findings may be applied in future work to identify personalized lifestyle and dietary supports to prevent and treat T2DM.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102882"},"PeriodicalIF":2.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy, carbohydrates and fats in clinical sports nutrition","authors":"Ana Karin Kozjek Schwietert ,&nbsp;Krištof Knap ,&nbsp;Gašper Tonin ,&nbsp;Nada Rotovnik Kozjek ,&nbsp;Michael Gleeson","doi":"10.1016/j.clnesp.2025.102900","DOIUrl":"10.1016/j.clnesp.2025.102900","url":null,"abstract":"<div><div>Energy metabolism plays a central role in supporting physical activity and athletic performance. In almost all forms of exercise different metabolic pathways and energy systems are used concurrently, with their relative contributions depending on exercise intensity, duration, fuel availability, environment, and physiological adaptations. Carbohydrates and fats both serve as the primary energy sources, with fat dominating during rest and low-intensity exercise, and carbohydrates becoming a preferential fuel at moderate to high exercise intensities. With longer duration of exercise, muscle energy stores become gradually depleted and blood glucose and adipose tissue derived fatty acids become increasingly important sources of energy. Prolonged exercise performance can be enhanced with exogenous carbohydrate supplementation in form of drinks, gels or snacks. Maintaining adequate energy and carbohydrate availability is crucial to support training and recovery and to prevent negative health consequences. While low-carbohydrate, high-fat diets may increase fat oxidation, they often impair performance at higher intensities. Individualised and periodised nutritional strategies that tailor energy and macronutrient intakes to meet the daily requirements of an active individual are essential to optimise health, support adaptations to exercise, and achieve training goals.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102900"},"PeriodicalIF":2.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor appetite and growth differentiation factor-15 as predictors of insufficient energy and protein intake during and after hospitalization in older adults with acute medical illness: Exploratory analysis of a randomized controlled trial","authors":"Olivia Bornæs ,&nbsp;Rikke Lundsgaard Nielsen ,&nbsp;Morten Baltzer Houlind ,&nbsp;Thomas Kallemose ,&nbsp;Baker Nawfal Jawad ,&nbsp;David Peick Sonne ,&nbsp;Ingrid Poulsen ,&nbsp;Aino Leegaard Andersen ,&nbsp;Mette Merete Pedersen","doi":"10.1016/j.clnesp.2025.102895","DOIUrl":"10.1016/j.clnesp.2025.102895","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Poor appetite is a key contributor to malnutrition in older adults, partly due to reduced dietary intake. While nutritional deficits are well recognized, the biological mechanisms driving poor appetite remain incompletely understood. Growth Differentiation Factor-15 (GDF-15) and the Simplified Nutritional Appetite Questionnaire (SNAQ) may help identify patients at risk of insufficient intake. This study examines the association between GDF-15 and insufficient energy and protein intake and evaluates the predictive performance of GDF-15 and SNAQ - individually and in combination - to identify insufficient energy and protein intake (&lt;75 % and &lt;100 % of estimated requirements, respectively) in acutely admitted older adults.</div></div><div><h3>Methods</h3><div>This exploratory study included 130 older adults (≥65 years) with or at risk of malnutrition, admitted for acute medical illness and assessed at baseline, and 8 and 16 weeks post-discharge (FW8 and FW16). GDF-15 plasma concentrations were measured from blood samples, SNAQ scores from validated questionnaire, and energy and protein intake were evaluated through 3-day dietary records. Associations were analyzed using regression models and predictive performance was evaluated using Receiver Operating Characteristic analysis.</div></div><div><h3>Results</h3><div>A doubling of GDF-15 showed a 6.73 % (−13.98–0.51) and 5.07 % (−12.18–2.05) lower baseline energy and protein intake, and results decreased after discharge. Using predefined cut-offs of ≥1500 pg/mL for GDF-15 and ≤14 for SNAQ, the highest positive predictive values (PPVs) were 86 (95 % CI: 0.83–0.89) and 90 (0.79–1.00) at baseline and FW8 for insufficient protein intake, respectively, with corresponding sensitivities of 84 (0.75–0.92) and 60 (0.44–0.74). For estimated cut-offs of 2095 pg/mL for GDF-15 at baseline and 18.5 for SNAQ at FW8, the highest PPVs were 89 (0.84–0.94) and 87 (0.86–0.87), with sensitivities of 73 (0.62–0.84) and 99 (0.96–1.00), both for insufficient protein intake, respectively. Combining GDF-15 and SNAQ yielded improved PPVs at the expense of reduced sensitivity in most models. All results were non-significant.</div></div><div><h3>Conclusion</h3><div>Higher GDF-15 levels showed a non-significant trend toward lower baseline energy and protein intake. GDF-15 and SNAQ offer limited ability to identify insufficient energy and protein intake, based on predictive performance. These exploratory findings should therefore be interpreted cautiously. Larger studies are needed to validate and further refine the use of GDF-15 and SNAQ in clinical settings.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102895"},"PeriodicalIF":2.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival of patients after a hip fracture: Influence of previous nutritional status on outcomes","authors":"M.C. Cervera-Díaz ,&nbsp;J.J. López-Gómez ,&nbsp;H.J. Aguado-Hernández ,&nbsp;V. García-Virto ,&nbsp;D. Rico-Bargues ,&nbsp;D.A. De Luis-Román","doi":"10.1016/j.clnesp.2025.102897","DOIUrl":"10.1016/j.clnesp.2025.102897","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia is a highly prevalent condition in patients with hip fracture; this condition can be related with prognosis. The main aim of this study was to investigate the survival rate of hip fracture inpatients and factors associated with mortality after six months and five years of the fracture event.</div></div><div><h3>Methods</h3><div>A real-world prospective study was carried out on 186 patients aged 75 years and older admitted after hip fracture, which were assessed within 48 h previous to surgical intervention. Hospitalized patients were able to walk before the fracture and showed no signs of cognitive impairment or chronic degenerative pathologies that posed a high risk of mortality. Integral Geriatric Assessment (IGA) was carried out at admission, at discharge, and after one, three and six months. Handgrip strength (HGS) was tested and lean tissue estimated through Bioelectrical Impedanciometry Analysis (BIA). Follow-up of all patients was carried out in order to record survival status or decease date. Mini-Nutritional Assessment (MNA) and European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were recorded to assess disease-related malnutrition (DRM) and sarcopenia.</div></div><div><h3>Results</h3><div>Age was 86.2 (75–104) years, with 81.7 % of women. Sarcopenia prevalence was of 59,1 % (with 76.9 % of patients showing low HGS and 73,7 % low estimated lean soft tissue. DRM was established in 81.2 % of patients, with 48,9 % of them showing both malnutrition and sarcopenia. Mortality within the first six months was 12.3 % increasing to 14,5 % and 51,6 % after one- and five-years follow-up respectively.The multivariate analyses identified the following significant factors associated with mortality across all subgroups: low handgrip (OR 3.61, 95 % CI (1.55–8.44; <em>p</em> &lt; 0.01), age &gt;85 years (OR 2.44; CI 1.24–4.81; <em>p</em> = 0.01), Barthel index at admission &lt;60 (OR 0.47, 95%CI 0.22–0.99; <em>p</em> = 0.049, and BMI &lt;22 kg/m² (OR 0.26; 95 % CI: 0.12–0.59; <em>p</em> &lt; 0.01))</div></div><div><h3>Conclusions</h3><div>Over half of hip fracture patients exhibit sarcopenia, with 81 % experiencing DRM, and nearly 50 % presenting both conditions simultaneously. Mortality at six months and five years is associated with sarcopenia, poorer nutritional status at the time of hospitalization, and a lower prefracture functional status.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102897"},"PeriodicalIF":2.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of nutrition impact symptoms with dietary intake among patients with advanced cancer referred to palliative care","authors":"Koji Amano ,&nbsp;Vickie E. Baracos ,&nbsp;Saori Koshimoto ,&nbsp;Tatsuma Sakaguchi ,&nbsp;Sayaka Arakawa ,&nbsp;Naoharu Mori","doi":"10.1016/j.clnesp.2025.102894","DOIUrl":"10.1016/j.clnesp.2025.102894","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Considering that cachexia-related symptoms interfere with dietary intake and compromise nutritional status in advanced cancer patients, these symptoms are classified as nutrition impact symptoms (NISs). However, the extent to which each NIS interferes with dietary intake remains unclear. Therefore, we examined the association between each NIS and dietary intake, considering the impact of an NIS cluster, and investigated the ability of each NIS to predict reduced dietary intake.</div></div><div><h3>Methods</h3><div>This is a secondary analysis using two datasets obtained from two surveys using a self-reported questionnaire conducted among advanced cancer patients referred to palliative care in multiple cancer hospitals. Participants evaluated 19 NISs (e.g., lack of appetite, early satiety, nausea, abnormal taste, and fatigue) and their dietary intake using a numerical rating scale (NRS) and the Ingesta-Verbal/Visual Analog Scale (IVVAS), respectively. To assess associations between each NIS and dietary intake, multivariate logistic regression analysis was performed adjusting for potential confounders, including four or more NISs with an NRS score of 4 or more as an NIS cluster. Values of the area under the curve (AUC) were also calculated for predicting a median IVVAS score or lower.</div></div><div><h3>Results</h3><div>Data were obtained from 328 participants in Survey 1 and 220 participants in Survey 2. Lack of appetite, early satiety, nausea, vomiting, abnormal taste, and fatigue were significantly associated with poor dietary intake (odds ratio [OR] 0.73, 95 % confidence interval [CI] 0.66–0.81; OR 0.84, 95 % CI 0.77–0.92; OR 0.80, 95 % CI 0.72–0.89; OR 0.80, 95 % CI 0.71–0.91; OR 0.91, 95 % CI 0.84–1.00; OR 0.90, 95 % CI 0.81–0.99, respectively). However, no significant association was observed for the other 13 NISs. All AUC values were greater than 0.750 for the 19 NISs. The highest AUC values were observed for lack of appetite, early satiety, and nausea (0.831, 95 % CI 0.797–0.866; 0.810, 95 % CI 0.773–0.848; 0.801, 95 % CI 0.764–0.838, respectively).</div></div><div><h3>Conclusions</h3><div>Lack of appetite, early satiety, nausea, vomiting, abnormal taste, and fatigue were significantly associated with dietary intake independently of the influence of other symptoms and other confounders. Furthermore, lack of appetite, early satiety, and nausea were good predictors for reduced dietary intake.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102894"},"PeriodicalIF":2.6,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic consequences when enteral tube feeding intolerance causes unplanned discontinuation in hospitalized older patients with gastroesophageal reflux disease","authors":"Yukikazu Kamada ,&nbsp;Kanako Kawano ,&nbsp;Akina Iguchi ,&nbsp;Noriko Tominaga ,&nbsp;Chisato Okamoto ,&nbsp;Masatoshi Inoue ,&nbsp;Ataru Igarashi ,&nbsp;Masafumi Kitakaze","doi":"10.1016/j.clnesp.2025.102892","DOIUrl":"10.1016/j.clnesp.2025.102892","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Enteral tube feeding intolerance (ETFI) is a common complication in older patients with gastroesophageal reflux disease (GERD), often leading to unplanned discontinuation of nutritional support. While the clinical consequences of ETFI are well-documented, its economic impact on hospital operations remains unclear. This study aimed to evaluate the financial consequences of ETFI-related discontinuation of enteral nutrition in hospitalized older patients with GERD, focusing on changes in medical resource allocation and hospital revenue under Japan's hybrid reimbursement system.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted using patient-level data from a long-term care ward in Japan between April 2018 and March 2021. Patients who initiated enteral tube feeding were categorized based on whether enteral feeding was discontinued due to intolerance. Medical claims data were analyzed to calculate fee-for-service (FFS) and fixed payment system (FPS) charges, unreimbursed medical charges (i.e., revenue loss under FPS), and inpatient living care expenses. Hospital loss simulations were performed based on discontinuation rates and patient characteristics.</div></div><div><h3>Results</h3><div>Among 149 patients, 23.5 % experienced ETFI-related discontinuation. These patients had significantly lower BMI and shorter feeding durations. Discontinuation was associated with increased unreimbursed medical charges (median JPY +2288/day (USD +15.2/day, USD 1.0 = JPY 150.80) at 1 week post-discontinuation) and decreased living care revenue (median JPY −1179/day (USD −7.82/day)). Multivariate analysis identified ETFI and low BMI (&lt;17.4) as independent predictors of increased hospital revenue losses. Simulations estimated a total loss of JPY 248,000 (USD 1644.56) per 10 hospitalized older patients with GERD over 4 weeks, with greater losses observed in low-BMI patients and those receiving polymeric formulas.</div></div><div><h3>Conclusion</h3><div>Unplanned discontinuation of enteral tube feeding due to intolerance in older patients with GERD imposes a substantial economic burden on hospitals, primarily through unreimbursed medical charges and reduced living care revenue. Preventive strategies—such as early nutritional intervention and formula selection—may mitigate these losses and support sustainable hospital management.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102892"},"PeriodicalIF":2.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global leadership initiative on malnutrition-based nutritional phenotype and factors associated with the outcomes of hospitalized patients managed by a nutrition support team: A retrospective study","authors":"Mathilde Barrallier ,&nbsp;Emeric Rageul ,&nbsp;Charlotte Nesseler ,&nbsp;Quentin Le Cornu ,&nbsp;Ronan Thibault","doi":"10.1016/j.clnesp.2025.102889","DOIUrl":"10.1016/j.clnesp.2025.102889","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and aims&lt;/h3&gt;&lt;div&gt;What are the Global Leadership Initiative on Malnutrition (GLIM) criteria leading to the diagnosis of malnutrition at hospital, specifically in diabetic patients, is not well known. The factors associated with the clinical outcomes of nutritionally at-risk hospitalized patients have been scarcely investigated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;To characterize the GLIM-based nutritional phenotype of hospitalized patients managed by a Nutrition Support Teams (NST) (primary), and to compare the GLIM malnutrition diagnostic criteria between diabetic and non-diabetic patients (secondary); to identify the factors associated with hospital readmission one month after discharge and one-month mortality (secondary).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective observational study including all the consecutive adult patients managed by the NST of a tertiary university hospital. The exclusion criteria were age under 18 yr and absence of assessment of body composition by bioimpedance analysis (BIA). Malnutrition was diagnosed according to the GLIM criteria: the etiologic criterion was the hospitalization for an acute or chronic disease, and three phenotypic criteria were: low body mass index (BMI), weight loss, and/or low fat-free mass index (FFMI) derived from BIA. Food intake was assessed by the Simple Evaluation of Food Intake® (SEFI®). Handgrip strength was measured using a dynamometer. Hospital readmission and death one month after discharge were collected from the electronic medical records (EMR). Multivariable logistic regression analyses using a stepwise top-down selection identified factors associated with one-month hospital readmission and mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;231 patients were included: 43 % of females, age (mean ± SD), 62.2 ± 15.9 yr, BMI, 23.5 ± 6.4, 73.6 % (170/231) were malnourished, of whom 66.5 % (113/170) had severe malnutrition, and 20.3 % (47/231) had diabetes. Malnutrition was diagnosed according to the three phenotypic criteria in 59/170 patients (34.7 %), two in 56/170 patients (33.1 %), and only one in 54/170 patients (31.8 %). The diabetic patients were less likely to have a low FFMI (29.8 % (14/47) vs 60.9 % (109/179), P &lt; 0.001) or be malnourished (61.7 % (29/47) vs 76.6 % (141/184), P = 0.04), but more likely to have a low handgrip strength (64.3 % (27/42) vs 45.6 % (68/149), P = 0.03) than non-diabetic patients. Multivariable analyses showed that cancer (odds ratio (OR) = 2.51 [1.17–5.37], P = 0.02) and SEFI® score (OR = 0.89 [95 % confidence interval, 0.79–0.99], P = 0.04) were associated with higher risk of hospital readmission, whereas weight loss (OR = 3.20 [1.26–8.17], P = 0.01) and diabetes (OR = 2.76 [1.10–6.91], P = 0.03) were associated with mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;One third of patients were diagnosed malnutrition with one phenotypic criterion, suggesting that all the GLIM phenotypic criteria should be used t","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102889"},"PeriodicalIF":2.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can the 13C-octanoic acid breath test accurately measure gastric emptying after sleeve gastrectomy and Roux-en-Y gastric bypass? A proof-of concept analysis","authors":"Nele Steenackers ,&nbsp;Patrick Augustijns ,&nbsp;Wies Deckers ,&nbsp;Ellen Deleus ,&nbsp;Christophe M. Deroose ,&nbsp;Matthias Lannoo ,&nbsp;Wei Li ,&nbsp;Ann Mertens ,&nbsp;Tim Vanuytsel ,&nbsp;Greet Vandermeulen ,&nbsp;Roman Vangoitsenhoven ,&nbsp;Kristin Verbeke ,&nbsp;Bart Van der Schueren ,&nbsp;Christophe Matthys","doi":"10.1016/j.clnesp.2025.102891","DOIUrl":"10.1016/j.clnesp.2025.102891","url":null,"abstract":"<div><h3>Background</h3><div>Bariatric surgery alters gastrointestinal anatomy and physiology, complicating functional assessments such as gastric emptying. The 13C-octanoic acid breath test is a simple, non-invasive alternative to scintigraphy, though its validity in bariatric populations requires further validation.</div></div><div><h3>Methods</h3><div>For this proof-of-concept analysis, gastric emptying data were derived from a cross-sectional study including individuals with obesity, sleeve gastrectomy, and Roux-en-Y gastric bypass (RYGB). Gastric emptying was measured simultaneously using the ¹³C-octanoic breath test and the reference method, scintigraphy. Gastric emptying half-times (GET_1/2) were compared between the two methods using Wilcoxon signed-rank tests in each group. Concordance between both methods was assessed using Kendall's tau correlation coefficients, and Bland–Altman plots.</div></div><div><h3>Results</h3><div>No significant inter-method differences were observed for GET_1/2 in any group. Mean differences were −26.7 min (95 % CI: −72.3; 18.6) for obesity, −3.92 min (95 % CI: −30.8; 23.0) for sleeve gastrectomy, and −8.55 min (95 % CI: −21.3; 4.18) for RYGB. Kendall's tau coefficients indicated positive rank associations within each group, but were non-significant (Obesity: 0.8, <em>P</em> = 0.16; sleeve gastrectomy: 0.90, <em>P</em> = 0.13; RYGB: 0.57, <em>P</em> = 0.33). Bland–Altman plots demonstrated acceptable agreement between the measurements across all groups.</div></div><div><h3>Conclusion</h3><div>This proof-of-concept analysis suggests that the 13C-octanoic acid breath test has potential as a valid, non-invasive method for assessing gastric emptying in post-bariatric surgery patients. However, larger validation studies are warranted to confirm these preliminary findings.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"71 ","pages":"Article 102891"},"PeriodicalIF":2.6,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body composition and functional status in the COVID-19 recovery phase: Prevalence of sarcopenia and sarcopenic obesity","authors":"Montserrat Montes-Ibarra ,&nbsp;Flavio T. Vieira ,&nbsp;Maria Cristina Gonzalez ,&nbsp;Alan Garcia-Grimaldo ,&nbsp;Ivan Armando Osuna-Padilla ,&nbsp;Andreia Bauermann-Vieira ,&nbsp;Edith Pituskin ,&nbsp;Richard B. Thompson ,&nbsp;D. Ian Paterson ,&nbsp;Carla M. Prado","doi":"10.1016/j.clnesp.2025.102877","DOIUrl":"10.1016/j.clnesp.2025.102877","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>COVID-19 may be associated with unfavourable body composition changes. This includes increased fat mass and decreased muscle mass, which can lead to sarcopenia and sarcopenic obesity (SO), conditions associated with impaired physical performance and reduced quality of life, among other adverse outcomes. This study investigated the prevalence of sarcopenia and SO in individuals who recovered from the first COVID-19 wave and their association with functional outcomes.</div></div><div><h3>Methods</h3><div>Clinical characteristics, body composition (bioelectrical impedance analysis), functional status (handgrip strength [HGS], 6-min walk test [6MWT]), and lung function (spirometry) were collected.</div></div><div><h3>Results</h3><div>37 individuals (89.2 % Caucasians, 64.9 % females, median age 48 years [IQR: 40; 60], 10.8 % &gt; 65y) were assessed after a median of 189 days (IQR: 169; 201) post-COVID-19 infection. The combined prevalence of sarcopenia/SO was 40.5 %, was identified in 37.8 %, while a single case (2.7 %) of sarcopenia without obesity was found. The sarcopenia/SO group had lower 6MWT and phase angle, and higher prevalence of hypertension. Sarcopenia/SO was negatively associated with 6MWT performance (β: −115.35, 95 % CI: −161.57 to −69.12), COVID-19 symptoms, disease severity, and duration were not associated with sarcopenia/SO diagnosis.</div></div><div><h3>Conclusion</h3><div>A high presence of sarcopenia/SO was identified and was negatively associated with health outcomes in individuals post-COVID-19. Thus, it is important to assess and address conditions associated with abnormal body composition after infectious diseases to better inform strategies for improving long-term outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102877"},"PeriodicalIF":2.6,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of transcranial direct current stimulation and nutritional counseling therapy on attentional bias to food cues: A randomized clinical trial","authors":"Jessica Lorenzzi Elkfury ,&nbsp;Luciana C. Antunes ,&nbsp;Gibson Weydmann ,&nbsp;Lizia Nardi Menegassi ,&nbsp;Liciane Fernandes Medeiros ,&nbsp;Tiago Madeira Cardinal ,&nbsp;Betina Franceschini Tocchetto ,&nbsp;Iraci L.S. Torres ,&nbsp;Felipe Fregni ,&nbsp;Lisiane Bizarro ,&nbsp;Wolnei Caumo","doi":"10.1016/j.clnesp.2025.102886","DOIUrl":"10.1016/j.clnesp.2025.102886","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This study investigated the effects of transcranial direct current stimulation (tDCS) and nutritional counseling therapy (NCT) on attentional bias (AB) in binge eating disorder.</div></div><div><h3>Methods</h3><div>This study was designed as a pilot randomized, factorial, blind, parallel-controlled clinical trial. Forty women were allocated to one of four groups: active tDCS (a-tDCS), a-tDCS + NCT, s-tDCS (sham tDCS) + NCT, NCT. The 28 home-based tDCS sessions were applied to the DLPFC (anode/right and cathode/left). The outcome was the delta values (pre- and post-treatment AB scores). Each AB score was calculated based on the stimulus onset asynchrony (SOA) at which stimuli were presented (100, 500, and 2000 ms).</div></div><div><h3>Results</h3><div>Mixed analyses of variance revealed a significant interaction between treatment and SOA (p = 0.035). The a-tDCS with NCT group showed a decrease in AB at an SOA of 500 ms. This decrease significantly differed from the increase observed in the s-tDCS with NCT group for the same SOA (p = 0.027). The a-tDCS with NCT group showed an increase in AB at an SOA of 2000 ms, which differed significantly from the decrease observed at the same SOA in the a-tDCS group (p = 0.032).</div></div><div><h3>Conclusions</h3><div>The combined therapy (a-tDCS with NCT) decreased AB at the pre-conscious orientation of attention and increased it when conscious orientation was possible.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov: NCT 04226794. Registered on July 2, 2019.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102886"},"PeriodicalIF":2.6,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}